Certified Hospice Program
Medicaid Rate Sheet
Effective: 10/01/2017 – 09/30/2018
- Rates also available in Excel Format (XLSX)
| Table of Contents |
|---|
| Albany–Schenectady–Troy |
| Binghamton |
| Buffalo |
| Elmira |
| Glens Falls |
| Nassau Suffolk |
| New York City |
| Niagara Falls |
| Orange County |
| Poughkeepsie |
| Rochester |
| Syracuse |
| Utica–Rome |
| Rural |
SMSA: Albany–Schenectady–Troy
Hospice Rate Sheets for the Counties of: ALBANY, GREENE, MONTGOMERY, RENSSELAER, SARATOGA, SCHENECTADY
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $141.76 | $4.25 | $9.92 | $155.93 |
| 3946 | Inpatient Respite | $164.32 | $4.93 | $9.92 | $179.17 |
| 3947 | General Inpatient Care | $658.69 | $19.76 | $9.92 | $688.37 |
| 3948 | Continuous Home Care – Min 8 Hours | $285.71 | $8.57 | $9.92 | $304.20 |
| 3949 | Continuous Home Care – Min 9 Hours | $321.42 | $9.64 | $9.92 | $340.98 |
| 3950 | Continuous Home Care – Min 10 Hours | $357.14 | $10.71 | $9.92 | $377.77 |
| 3951 | Continuous Home Care – Min 11 Hours | $392.85 | $11.79 | $9.92 | $414.56 |
| 3952 | Continuous Home Care – Min 12 Hours | $428.57 | $12.86 | $9.92 | $451.35 |
| 3953 | Continuous Home Care – Min 13 Hours | $464.28 | $13.93 | $9.92 | $488.13 |
| 3954 | Continuous Home Care – Min 14 Hours | $499.99 | $15.00 | $9.92 | $524.91 |
| 3955 | Continuous Home Care – Min 15 Hours | $535.71 | $16.07 | $9.92 | $561.70 |
| 3956 | Continuous Home Care – Min 16 Hours | $571.42 | $17.14 | $9.92 | $598.48 |
| 3957 | Continuous Home Care – Min 17 Hours | $607.13 | $18.21 | $9.92 | $635.26 |
| 3958 | Continuous Home Care – Min 18 Hours | $642.85 | $19.29 | $9.92 | $672.06 |
| 3959 | Continuous Home Care – Min 19 Hours | $678.56 | $20.36 | $9.92 | $708.84 |
| 3960 | Continuous Home Care – Min 20 Hours | $714.28 | $21.43 | $9.92 | $745.63 |
| 3961 | Continuous Home Care – Min 21 Hours | $749.99 | $22.50 | $9.92 | $782.41 |
| 3962 | Continuous Home Care – Min 22 Hours | $785.70 | $23.57 | $9.92 | $819.19 |
| 3963 | Continuous Home Care – Min 23 Hours | $821.42 | $24.64 | $9.92 | $855.98 |
| 3964 | Continuous Home Care – Min 24 Hours | $857.13 | $25.71 | $9.92 | $892.76 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.22 | $0.25 | $0.50 | $8.97 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $245.57 | $7.37 | $9.92 | $262.86 |
| 3970 | Routine Home Care w/Escort | $159.50 | $4.79 | $9.92 | $174.21 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $299.41 | $8.98 | $9.92 | $318.31 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $336.84 | $10.11 | $9.92 | $356.87 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $374.26 | $11.23 | $9.92 | $395.41 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $411.69 | $12.35 | $9.92 | $433.96 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $449.12 | $13.47 | $9.92 | $472.51 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $486.54 | $14.60 | $9.92 | $511.06 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $523.97 | $15.72 | $9.92 | $549.61 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $561.39 | $16.84 | $9.92 | $588.15 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $598.82 | $17.96 | $9.92 | $626.70 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $636.25 | $19.09 | $9.92 | $665.26 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $673.67 | $20.21 | $9.92 | $703.80 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $711.10 | $21.33 | $9.92 | $742.35 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $748.53 | $22.46 | $9.92 | $780.91 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $785.95 | $23.58 | $9.92 | $819.45 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $823.38 | $24.70 | $9.92 | $858.00 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $860.80 | $25.82 | $9.92 | $896.54 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $898.23 | $26.95 | $9.92 | $935.10 |
| 3988 | General Inpatient w/ AIDS | $732.07 | $21.96 | $9.92 | $763.95 |
| 3989 | Routine Home Care w/ AIDS Escort | $263.31 | $7.90 | $9.92 | $281.13 |
| 3991 | Service Intensity Add–on | $36.95 | $1.11 | $0.00 | $38.06 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Binghamton
Hospice Rate Sheets for the Counties of: BROOME, TIOGA
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $145.13 | $4.35 | $9.92 | $159.40 |
| 3946 | Inpatient Respite | $167.31 | $5.02 | $9.92 | $182.25 |
| 3947 | General Inpatient Care | $673.16 | $20.19 | $9.92 | $703.27 |
| 3948 | Continuous Home Care – Min 8 Hours | $292.51 | $8.78 | $9.92 | $311.21 |
| 3949 | Continuous Home Care – Min 9 Hours | $329.08 | $9.87 | $9.92 | $348.87 |
| 3950 | Continuous Home Care – Min 10 Hours | $365.64 | $10.97 | $9.92 | $386.53 |
| 3951 | Continuous Home Care – Min 11 Hours | $402.21 | $12.07 | $9.92 | $424.20 |
| 3952 | Continuous Home Care – Min 12 Hours | $438.77 | $13.16 | $9.92 | $461.85 |
| 3953 | Continuous Home Care – Min 13 Hours | $475.33 | $14.26 | $9.92 | $499.51 |
| 3954 | Continuous Home Care – Min 14 Hours | $511.90 | $15.36 | $9.92 | $537.18 |
| 3955 | Continuous Home Care – Min 15 Hours | $548.46 | $16.45 | $9.92 | $574.83 |
| 3956 | Continuous Home Care – Min 16 Hours | $585.03 | $17.55 | $9.92 | $612.50 |
| 3957 | Continuous Home Care – Min 17 Hours | $621.59 | $18.65 | $9.92 | $650.16 |
| 3958 | Continuous Home Care – Min 18 Hours | $658.16 | $19.74 | $9.92 | $687.82 |
| 3959 | Continuous Home Care – Min 19 Hours | $694.72 | $20.84 | $9.92 | $725.48 |
| 3960 | Continuous Home Care – Min 20 Hours | $731.28 | $21.94 | $9.92 | $763.14 |
| 3961 | Continuous Home Care – Min 21 Hours | $767.85 | $23.04 | $9.92 | $800.81 |
| 3962 | Continuous Home Care – Min 22 Hours | $804.41 | $24.13 | $9.92 | $838.46 |
| 3963 | Continuous Home Care – Min 23 Hours | $840.98 | $25.23 | $9.92 | $876.13 |
| 3964 | Continuous Home Care – Min 24 Hours | $877.54 | $26.33 | $9.92 | $913.79 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.37 | $0.25 | $0.50 | $9.12 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $251.42 | $7.54 | $9.92 | $268.88 |
| 3970 | Routine Home Care w/Escort | $162.87 | $4.89 | $9.92 | $177.68 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $309.46 | $9.28 | $9.92 | $328.66 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $348.14 | $10.44 | $9.92 | $368.50 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $386.83 | $11.60 | $9.92 | $408.35 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $425.51 | $12.77 | $9.92 | $448.20 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $464.19 | $13.93 | $9.92 | $488.04 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $502.87 | $15.09 | $9.92 | $527.88 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $541.56 | $16.25 | $9.92 | $567.73 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $580.24 | $17.41 | $9.92 | $607.57 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $618.92 | $18.57 | $9.92 | $647.41 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $657.60 | $19.73 | $9.92 | $687.25 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $696.29 | $20.89 | $9.92 | $727.10 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $734.97 | $22.05 | $9.92 | $766.94 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $773.65 | $23.21 | $9.92 | $806.78 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $812.33 | $24.37 | $9.92 | $846.62 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $851.02 | $25.53 | $9.92 | $886.47 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $889.70 | $26.69 | $9.92 | $926.31 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $928.38 | $27.85 | $9.92 | $966.15 |
| 3988 | General Inpatient w/ AIDS | $748.15 | $22.44 | $9.92 | $780.51 |
| 3989 | Routine Home Care w/ AIDS Escort | $269.16 | $8.07 | $9.92 | $287.15 |
| 3991 | Service Intensity Add–on | $37.83 | $1.13 | $0.00 | $38.96 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Buffalo
Hospice Rate Sheets for the Counties of: ERIE
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $167.17 | $5.02 | $9.92 | $182.11 |
| 3946 | Inpatient Respite | $186.85 | $5.61 | $9.92 | $202.38 |
| 3947 | General Inpatient Care | $767.63 | $23.03 | $9.92 | $800.58 |
| 3948 | Continuous Home Care – Min 8 Hours | $336.92 | $10.11 | $9.92 | $356.95 |
| 3949 | Continuous Home Care – Min 9 Hours | $379.04 | $11.37 | $9.92 | $400.33 |
| 3950 | Continuous Home Care – Min 10 Hours | $421.15 | $12.63 | $9.92 | $443.70 |
| 3951 | Continuous Home Care – Min 11 Hours | $463.27 | $13.90 | $9.92 | $487.09 |
| 3952 | Continuous Home Care – Min 12 Hours | $505.38 | $15.16 | $9.92 | $530.46 |
| 3953 | Continuous Home Care – Min 13 Hours | $547.50 | $16.43 | $9.92 | $573.85 |
| 3954 | Continuous Home Care – Min 14 Hours | $589.61 | $17.69 | $9.92 | $617.22 |
| 3955 | Continuous Home Care – Min 15 Hours | $631.73 | $18.95 | $9.92 | $660.60 |
| 3956 | Continuous Home Care – Min 16 Hours | $673.84 | $20.22 | $9.92 | $703.98 |
| 3957 | Continuous Home Care – Min 17 Hours | $715.96 | $21.48 | $9.92 | $747.36 |
| 3958 | Continuous Home Care – Min 18 Hours | $758.07 | $22.74 | $9.92 | $790.73 |
| 3959 | Continuous Home Care – Min 19 Hours | $800.19 | $24.01 | $9.92 | $834.12 |
| 3960 | Continuous Home Care – Min 20 Hours | $842.30 | $25.27 | $9.92 | $877.49 |
| 3961 | Continuous Home Care – Min 21 Hours | $884.42 | $26.53 | $9.92 | $920.87 |
| 3962 | Continuous Home Care – Min 22 Hours | $926.53 | $27.80 | $9.92 | $964.25 |
| 3963 | Continuous Home Care – Min 23 Hours | $968.65 | $29.06 | $9.92 | $1,007.63 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,010.76 | $30.32 | $9.92 | $1,051.00 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $9.34 | $0.28 | $0.50 | $10.12 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $289.59 | $8.69 | $9.92 | $308.20 |
| 3970 | Routine Home Care w/Escort | $184.91 | $5.55 | $9.92 | $200.38 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $375.07 | $11.25 | $9.92 | $396.24 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $421.96 | $12.66 | $9.92 | $444.54 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $468.84 | $14.07 | $9.92 | $492.83 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $515.73 | $15.47 | $9.92 | $541.12 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $562.61 | $16.88 | $9.92 | $589.41 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $609.49 | $18.28 | $9.92 | $637.69 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $656.38 | $19.69 | $9.92 | $685.99 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $703.26 | $21.10 | $9.92 | $734.28 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $750.15 | $22.50 | $9.92 | $782.57 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $797.03 | $23.91 | $9.92 | $830.86 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $843.92 | $25.32 | $9.92 | $879.16 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $890.80 | $26.72 | $9.92 | $927.44 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $937.68 | $28.13 | $9.92 | $975.73 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $984.57 | $29.54 | $9.92 | $1,024.03 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,031.45 | $30.94 | $9.92 | $1,072.31 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,078.34 | $32.35 | $9.92 | $1,120.61 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,125.22 | $33.76 | $9.92 | $1,168.90 |
| 3988 | General Inpatient w/ AIDS | $853.14 | $25.59 | $9.92 | $888.65 |
| 3989 | Routine Home Care w/ AIDS Escort | $307.33 | $9.22 | $9.92 | $326.47 |
| 3991 | Service Intensity Add–on | $43.57 | $1.31 | $0.00 | $44.88 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Elmira
Hospice Rate Sheets for the Counties of: CHEMUNG
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $148.16 | $4.44 | $9.92 | $162.52 |
| 3946 | Inpatient Respite | $170.00 | $5.10 | $9.92 | $185.02 |
| 3947 | General Inpatient Care | $686.15 | $20.58 | $9.92 | $716.65 |
| 3948 | Continuous Home Care – Min 8 Hours | $298.62 | $8.96 | $9.92 | $317.50 |
| 3949 | Continuous Home Care – Min 9 Hours | $335.95 | $10.08 | $9.92 | $355.95 |
| 3950 | Continuous Home Care – Min 10 Hours | $373.28 | $11.20 | $9.92 | $394.40 |
| 3951 | Continuous Home Care – Min 11 Hours | $410.60 | $12.32 | $9.92 | $432.84 |
| 3952 | Continuous Home Care – Min 12 Hours | $447.93 | $13.44 | $9.92 | $471.29 |
| 3953 | Continuous Home Care – Min 13 Hours | $485.26 | $14.56 | $9.92 | $509.74 |
| 3954 | Continuous Home Care – Min 14 Hours | $522.59 | $15.68 | $9.92 | $548.19 |
| 3955 | Continuous Home Care – Min 15 Hours | $559.91 | $16.80 | $9.92 | $586.63 |
| 3956 | Continuous Home Care – Min 16 Hours | $597.24 | $17.92 | $9.92 | $625.08 |
| 3957 | Continuous Home Care – Min 17 Hours | $634.57 | $19.04 | $9.92 | $663.53 |
| 3958 | Continuous Home Care – Min 18 Hours | $671.90 | $20.16 | $9.92 | $701.98 |
| 3959 | Continuous Home Care – Min 19 Hours | $709.22 | $21.28 | $9.92 | $740.42 |
| 3960 | Continuous Home Care – Min 20 Hours | $746.55 | $22.40 | $9.92 | $778.87 |
| 3961 | Continuous Home Care – Min 21 Hours | $783.88 | $23.52 | $9.92 | $817.32 |
| 3962 | Continuous Home Care – Min 22 Hours | $821.21 | $24.64 | $9.92 | $855.77 |
| 3963 | Continuous Home Care – Min 23 Hours | $858.53 | $25.76 | $9.92 | $894.21 |
| 3964 | Continuous Home Care – Min 24 Hours | $895.86 | $26.88 | $9.92 | $932.66 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.50 | $0.26 | $0.50 | $9.26 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $256.67 | $7.70 | $9.92 | $274.29 |
| 3970 | Routine Home Care w/Escort | $165.90 | $4.98 | $9.92 | $180.80 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $318.48 | $9.55 | $9.92 | $337.95 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $358.29 | $10.75 | $9.92 | $378.96 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $398.10 | $11.94 | $9.92 | $419.96 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $437.91 | $13.14 | $9.92 | $460.97 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $477.73 | $14.33 | $9.92 | $501.98 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $517.54 | $15.53 | $9.92 | $542.99 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $557.35 | $16.72 | $9.92 | $583.99 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $597.16 | $17.91 | $9.92 | $624.99 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $636.97 | $19.11 | $9.92 | $666.00 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $676.78 | $20.30 | $9.92 | $707.00 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $716.59 | $21.50 | $9.92 | $748.01 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $756.40 | $22.69 | $9.92 | $789.01 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $796.21 | $23.89 | $9.92 | $830.02 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $836.02 | $25.08 | $9.92 | $871.02 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $875.83 | $26.27 | $9.92 | $912.02 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $915.64 | $27.47 | $9.92 | $953.03 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $955.45 | $28.66 | $9.92 | $994.03 |
| 3988 | General Inpatient w/ AIDS | $762.59 | $22.88 | $9.92 | $795.39 |
| 3989 | Routine Home Care w/ AIDS Escort | $274.41 | $8.23 | $9.92 | $292.56 |
| 3991 | Service Intensity Add–on | $38.62 | $1.16 | $0.00 | $39.78 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Glens Falls
Hospice Rate Sheets for the Counties of:WARREN, WASHINGTON
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $139.82 | $4.19 | $9.92 | $153.93 |
| 3946 | Inpatient Respite | $162.59 | $4.88 | $9.92 | $177.39 |
| 3947 | General Inpatient Care | $650.36 | $19.51 | $9.92 | $679.79 |
| 3948 | Continuous Home Care – Min 8 Hours | $281.80 | $8.45 | $9.92 | $300.17 |
| 3949 | Continuous Home Care – Min 9 Hours | $317.02 | $9.51 | $9.92 | $336.45 |
| 3950 | Continuous Home Care – Min 10 Hours | $352.25 | $10.57 | $9.92 | $372.74 |
| 3951 | Continuous Home Care – Min 11 Hours | $387.47 | $11.62 | $9.92 | $409.01 |
| 3952 | Continuous Home Care – Min 12 Hours | $422.70 | $12.68 | $9.92 | $445.30 |
| 3953 | Continuous Home Care – Min 13 Hours | $457.92 | $13.74 | $9.92 | $481.58 |
| 3954 | Continuous Home Care – Min 14 Hours | $493.14 | $14.79 | $9.92 | $517.85 |
| 3955 | Continuous Home Care – Min 15 Hours | $528.37 | $15.85 | $9.92 | $554.14 |
| 3956 | Continuous Home Care – Min 16 Hours | $563.59 | $16.91 | $9.92 | $590.42 |
| 3957 | Continuous Home Care – Min 17 Hours | $598.82 | $17.96 | $9.92 | $626.70 |
| 3958 | Continuous Home Care – Min 18 Hours | $634.04 | $19.02 | $9.92 | $662.98 |
| 3959 | Continuous Home Care – Min 19 Hours | $669.27 | $20.08 | $9.92 | $699.27 |
| 3960 | Continuous Home Care – Min 20 Hours | $704.49 | $21.13 | $9.92 | $735.54 |
| 3961 | Continuous Home Care – Min 21 Hours | $739.72 | $22.19 | $9.92 | $771.83 |
| 3962 | Continuous Home Care – Min 22 Hours | $774.94 | $23.25 | $9.92 | $808.11 |
| 3963 | Continuous Home Care – Min 23 Hours | $810.17 | $24.31 | $9.92 | $844.40 |
| 3964 | Continuous Home Care – Min 24 Hours | $845.39 | $25.36 | $9.92 | $880.67 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.13 | $0.24 | $0.50 | $8.87 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $242.21 | $7.27 | $9.92 | $259.40 |
| 3970 | Routine Home Care w/Escort | $157.56 | $4.73 | $9.92 | $172.21 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $293.63 | $8.81 | $9.92 | $312.36 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $330.33 | $9.91 | $9.92 | $350.16 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $367.03 | $11.01 | $9.92 | $387.96 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $403.74 | $12.11 | $9.92 | $425.77 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $440.44 | $13.21 | $9.92 | $463.57 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $477.14 | $14.31 | $9.92 | $501.37 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $513.85 | $15.42 | $9.92 | $539.19 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $550.55 | $16.52 | $9.92 | $576.99 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $587.25 | $17.62 | $9.92 | $614.79 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $623.96 | $18.72 | $9.92 | $652.60 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $660.66 | $19.82 | $9.92 | $690.40 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $697.36 | $20.92 | $9.92 | $728.20 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $734.07 | $22.02 | $9.92 | $766.01 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $770.77 | $23.12 | $9.92 | $803.81 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $807.47 | $24.22 | $9.92 | $841.61 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $844.18 | $25.33 | $9.92 | $879.43 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $880.88 | $26.43 | $9.92 | $917.23 |
| 3988 | General Inpatient w/ AIDS | $722.81 | $21.68 | $9.92 | $754.41 |
| 3989 | Routine Home Care w/ AIDS Escort | $259.95 | $7.80 | $9.92 | $277.67 |
| 3991 | Service Intensity Add–on | $36.45 | $1.09 | $0.00 | $37.54 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Nassau Suffolk
Hospice Rate Sheets for the Counties of: NASSAU, SUFFOLK
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $191.53 | $5.75 | $9.92 | $207.20 |
| 3946 | Inpatient Respite | $208.46 | $6.25 | $9.92 | $224.63 |
| 3947 | General Inpatient Care | $872.10 | $26.16 | $9.92 | $908.18 |
| 3948 | Continuous Home Care – Min 8 Hours | $386.03 | $11.58 | $9.92 | $407.53 |
| 3949 | Continuous Home Care – Min 9 Hours | $434.28 | $13.03 | $9.92 | $457.23 |
| 3950 | Continuous Home Care – Min 10 Hours | $482.53 | $14.48 | $9.92 | $506.93 |
| 3951 | Continuous Home Care – Min 11 Hours | $530.79 | $15.92 | $9.92 | $556.63 |
| 3952 | Continuous Home Care – Min 12 Hours | $579.04 | $17.37 | $9.92 | $606.33 |
| 3953 | Continuous Home Care – Min 13 Hours | $627.29 | $18.82 | $9.92 | $656.03 |
| 3954 | Continuous Home Care – Min 14 Hours | $675.55 | $20.27 | $9.92 | $705.74 |
| 3955 | Continuous Home Care – Min 15 Hours | $723.80 | $21.71 | $9.92 | $755.43 |
| 3956 | Continuous Home Care – Min 16 Hours | $772.05 | $23.16 | $9.92 | $805.13 |
| 3957 | Continuous Home Care – Min 17 Hours | $820.31 | $24.61 | $9.92 | $854.84 |
| 3958 | Continuous Home Care – Min 18 Hours | $868.56 | $26.06 | $9.92 | $904.54 |
| 3959 | Continuous Home Care – Min 19 Hours | $916.81 | $27.50 | $9.92 | $954.23 |
| 3960 | Continuous Home Care – Min 20 Hours | $965.07 | $28.95 | $9.92 | $1,003.94 |
| 3961 | Continuous Home Care – Min 21 Hours | $1,013.32 | $30.40 | $9.92 | $1,053.64 |
| 3962 | Continuous Home Care – Min 22 Hours | $1,061.57 | $31.85 | $9.92 | $1,103.34 |
| 3963 | Continuous Home Care – Min 23 Hours | $1,109.83 | $33.29 | $9.92 | $1,153.04 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,158.08 | $34.74 | $9.92 | $1,202.74 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $10.42 | $0.31 | $0.50 | $11.23 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $331.80 | $9.95 | $9.92 | $351.67 |
| 3970 | Routine Home Care w/Escort | $209.27 | $6.28 | $9.92 | $225.47 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $447.63 | $13.43 | $9.92 | $470.98 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $503.58 | $15.11 | $9.92 | $528.61 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $559.53 | $16.79 | $9.92 | $586.24 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $615.49 | $18.46 | $9.92 | $643.87 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $671.44 | $20.14 | $9.92 | $701.50 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $727.39 | $21.82 | $9.92 | $759.13 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $783.35 | $23.50 | $9.92 | $816.77 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $839.30 | $25.18 | $9.92 | $874.40 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $895.25 | $26.86 | $9.92 | $932.03 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $951.21 | $28.54 | $9.92 | $989.67 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,007.16 | $30.21 | $9.92 | $1,047.29 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,063.11 | $31.89 | $9.92 | $1,104.92 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,119.07 | $33.57 | $9.92 | $1,162.56 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,175.02 | $35.25 | $9.92 | $1,220.19 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,230.97 | $36.93 | $9.92 | $1,277.82 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,286.93 | $38.61 | $9.92 | $1,335.46 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,342.88 | $40.29 | $9.92 | $1,393.09 |
| 3988 | General Inpatient w/ AIDS | $969.25 | $29.08 | $9.92 | $1,008.25 |
| 3989 | Routine Home Care w/ AIDS Escort | $349.54 | $10.49 | $9.92 | $369.95 |
| 3991 | Service Intensity Add–on | $49.92 | $1.50 | $0.00 | $51.42 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: New York City
Hospice Rate Sheets for the Counties of: BRONX, KINGS, NEW YORK, PUTNAM, QUEENS, RICHMOND, ROCKLAND, WESTCHESTER
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $193.61 | $5.81 | $9.92 | $209.34 |
| 3946 | Inpatient Respite | $210.30 | $6.31 | $9.92 | $226.53 |
| 3947 | General Inpatient Care | $881.00 | $26.43 | $9.92 | $917.35 |
| 3948 | Continuous Home Care – Min 8 Hours | $390.21 | $11.71 | $9.92 | $411.84 |
| 3949 | Continuous Home Care – Min 9 Hours | $438.99 | $13.17 | $9.92 | $462.08 |
| 3950 | Continuous Home Care – Min 10 Hours | $487.76 | $14.63 | $9.92 | $512.31 |
| 3951 | Continuous Home Care – Min 11 Hours | $536.54 | $16.10 | $9.92 | $562.56 |
| 3952 | Continuous Home Care – Min 12 Hours | $585.32 | $17.56 | $9.92 | $612.80 |
| 3953 | Continuous Home Care – Min 13 Hours | $634.09 | $19.02 | $9.92 | $663.03 |
| 3954 | Continuous Home Care – Min 14 Hours | $682.87 | $20.49 | $9.92 | $713.28 |
| 3955 | Continuous Home Care – Min 15 Hours | $731.64 | $21.95 | $9.92 | $763.51 |
| 3956 | Continuous Home Care – Min 16 Hours | $780.42 | $23.41 | $9.92 | $813.75 |
| 3957 | Continuous Home Care – Min 17 Hours | $829.20 | $24.88 | $9.92 | $864.00 |
| 3958 | Continuous Home Care – Min 18 Hours | $877.97 | $26.34 | $9.92 | $914.23 |
| 3959 | Continuous Home Care – Min 19 Hours | $926.75 | $27.80 | $9.92 | $964.47 |
| 3960 | Continuous Home Care – Min 20 Hours | $975.53 | $29.27 | $9.92 | $1,014.72 |
| 3961 | Continuous Home Care – Min 21 Hours | $1,024.30 | $30.73 | $9.92 | $1,064.95 |
| 3962 | Continuous Home Care – Min 22 Hours | $1,073.08 | $32.19 | $9.92 | $1,115.19 |
| 3963 | Continuous Home Care – Min 23 Hours | $1,121.85 | $33.66 | $9.92 | $1,165.43 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,170.63 | $35.12 | $9.92 | $1,215.67 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $10.52 | $0.32 | $0.50 | $11.34 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $335.39 | $10.06 | $9.92 | $355.37 |
| 3970 | Routine Home Care w/Escort | $211.35 | $6.34 | $9.92 | $227.61 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $453.81 | $13.61 | $9.92 | $477.34 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $510.53 | $15.32 | $9.92 | $535.77 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $567.26 | $17.02 | $9.92 | $594.20 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $623.98 | $18.72 | $9.92 | $652.62 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $680.71 | $20.42 | $9.92 | $711.05 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $737.44 | $22.12 | $9.92 | $769.48 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $794.16 | $23.82 | $9.92 | $827.90 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $850.89 | $25.53 | $9.92 | $886.34 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $907.61 | $27.23 | $9.92 | $944.76 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $964.34 | $28.93 | $9.92 | $1,003.19 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,021.07 | $30.63 | $9.92 | $1,061.62 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,077.79 | $32.33 | $9.92 | $1,120.04 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,134.52 | $34.04 | $9.92 | $1,178.48 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,191.24 | $35.74 | $9.92 | $1,236.90 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,247.97 | $37.44 | $9.92 | $1,295.33 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,304.69 | $39.14 | $9.92 | $1,353.75 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,361.42 | $40.84 | $9.92 | $1,412.18 |
| 3988 | General Inpatient w/ AIDS | $979.14 | $29.37 | $9.92 | $1,018.43 |
| 3989 | Routine Home Care w/ AIDS Escort | $353.13 | $10.59 | $9.92 | $373.64 |
| 3991 | Service Intensity Add–on | $50.46 | $1.51 | $0.00 | $51.97 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Niagara Falls
Hospice Rate Sheets for the Counties of: NIAGARA
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $167.17 | $5.02 | $9.92 | $182.11 |
| 3946 | Inpatient Respite | $186.85 | $5.61 | $9.92 | $202.38 |
| 3947 | General Inpatient Care | $767.63 | $23.03 | $9.92 | $800.58 |
| 3948 | Continuous Home Care – Min 8 Hours | $336.92 | $10.11 | $9.92 | $356.95 |
| 3949 | Continuous Home Care – Min 9 Hours | $379.04 | $11.37 | $9.92 | $400.33 |
| 3950 | Continuous Home Care – Min 10 Hours | $421.15 | $12.63 | $9.92 | $443.70 |
| 3951 | Continuous Home Care – Min 11 Hours | $463.27 | $13.90 | $9.92 | $487.09 |
| 3952 | Continuous Home Care – Min 12 Hours | $505.38 | $15.16 | $9.92 | $530.46 |
| 3953 | Continuous Home Care – Min 13 Hours | $547.50 | $16.43 | $9.92 | $573.85 |
| 3954 | Continuous Home Care – Min 14 Hours | $589.61 | $17.69 | $9.92 | $617.22 |
| 3955 | Continuous Home Care – Min 15 Hours | $631.73 | $18.95 | $9.92 | $660.60 |
| 3956 | Continuous Home Care – Min 16 Hours | $673.84 | $20.22 | $9.92 | $703.98 |
| 3957 | Continuous Home Care – Min 17 Hours | $715.96 | $21.48 | $9.92 | $747.36 |
| 3958 | Continuous Home Care – Min 18 Hours | $758.07 | $22.74 | $9.92 | $790.73 |
| 3959 | Continuous Home Care – Min 19 Hours | $800.19 | $24.01 | $9.92 | $834.12 |
| 3960 | Continuous Home Care – Min 20 Hours | $842.30 | $25.27 | $9.92 | $877.49 |
| 3961 | Continuous Home Care – Min 21 Hours | $884.42 | $26.53 | $9.92 | $920.87 |
| 3962 | Continuous Home Care – Min 22 Hours | $926.53 | $27.80 | $9.92 | $964.25 |
| 3963 | Continuous Home Care – Min 23 Hours | $968.65 | $29.06 | $9.92 | $1,007.63 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,010.76 | $30.32 | $9.92 | $1,051.00 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $9.34 | $0.28 | $0.50 | $10.12 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $289.59 | $8.69 | $9.92 | $308.20 |
| 3970 | Routine Home Care w/Escort | $184.91 | $5.55 | $9.92 | $200.38 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $375.07 | $11.25 | $9.92 | $396.24 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $421.96 | $12.66 | $9.92 | $444.54 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $468.84 | $14.07 | $9.92 | $492.83 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $515.73 | $15.47 | $9.92 | $541.12 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $562.61 | $16.88 | $9.92 | $589.41 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $609.49 | $18.28 | $9.92 | $637.69 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $656.38 | $19.69 | $9.92 | $685.99 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $703.26 | $21.10 | $9.92 | $734.28 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $750.15 | $22.50 | $9.92 | $782.57 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $797.03 | $23.91 | $9.92 | $830.86 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $843.92 | $25.32 | $9.92 | $879.16 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $890.80 | $26.72 | $9.92 | $927.44 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $937.68 | $28.13 | $9.92 | $975.73 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $984.57 | $29.54 | $9.92 | $1,024.03 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,031.45 | $30.94 | $9.92 | $1,072.31 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,078.34 | $32.35 | $9.92 | $1,120.61 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,125.22 | $33.76 | $9.92 | $1,168.90 |
| 3988 | General Inpatient w/ AIDS | $853.14 | $25.59 | $9.92 | $888.65 |
| 3989 | Routine Home Care w/ AIDS Escort | $307.33 | $9.22 | $9.92 | $326.47 |
| 3991 | Service Intensity Add–on | $43.57 | $1.31 | $0.00 | $44.88 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Orange
Hospice Rate Sheets for the Counties of: ORANGE
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $193.61 | $5.81 | $9.92 | $209.34 |
| 3946 | Inpatient Respite | $210.30 | $6.31 | $9.92 | $226.53 |
| 3947 | General Inpatient Care | $881.00 | $26.43 | $9.92 | $917.35 |
| 3948 | Continuous Home Care – Min 8 Hours | $390.21 | $11.71 | $9.92 | $411.84 |
| 3949 | Continuous Home Care – Min 9 Hours | $438.99 | $13.17 | $9.92 | $462.08 |
| 3950 | Continuous Home Care – Min 10 Hours | $487.76 | $14.63 | $9.92 | $512.31 |
| 3951 | Continuous Home Care – Min 11 Hours | $536.54 | $16.10 | $9.92 | $562.56 |
| 3952 | Continuous Home Care – Min 12 Hours | $585.32 | $17.56 | $9.92 | $612.80 |
| 3953 | Continuous Home Care – Min 13 Hours | $634.09 | $19.02 | $9.92 | $663.03 |
| 3954 | Continuous Home Care – Min 14 Hours | $682.87 | $20.49 | $9.92 | $713.28 |
| 3955 | Continuous Home Care – Min 15 Hours | $731.64 | $21.95 | $9.92 | $763.51 |
| 3956 | Continuous Home Care – Min 16 Hours | $780.42 | $23.41 | $9.92 | $813.75 |
| 3957 | Continuous Home Care – Min 17 Hours | $829.20 | $24.88 | $9.92 | $864.00 |
| 3958 | Continuous Home Care – Min 18 Hours | $877.97 | $26.34 | $9.92 | $914.23 |
| 3959 | Continuous Home Care – Min 19 Hours | $926.75 | $27.80 | $9.92 | $964.47 |
| 3960 | Continuous Home Care – Min 20 Hours | $975.53 | $29.27 | $9.92 | $1,014.72 |
| 3961 | Continuous Home Care – Min 21 Hours | $1,024.30 | $30.73 | $9.92 | $1,064.95 |
| 3962 | Continuous Home Care – Min 22 Hours | $1,073.08 | $32.19 | $9.92 | $1,115.19 |
| 3963 | Continuous Home Care – Min 23 Hours | $1,121.85 | $33.66 | $9.92 | $1,165.43 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,170.63 | $35.12 | $9.92 | $1,215.67 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $10.52 | $0.32 | $0.50 | $11.34 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $335.39 | $10.06 | $9.92 | $355.37 |
| 3970 | Routine Home Care w/Escort | $211.35 | $6.34 | $9.92 | $227.61 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $453.81 | $13.61 | $9.92 | $477.34 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $510.53 | $15.32 | $9.92 | $535.77 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $567.26 | $17.02 | $9.92 | $594.20 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $623.98 | $18.72 | $9.92 | $652.62 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $680.71 | $20.42 | $9.92 | $711.05 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $737.44 | $22.12 | $9.92 | $769.48 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $794.16 | $23.82 | $9.92 | $827.90 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $850.89 | $25.53 | $9.92 | $886.34 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $907.61 | $27.23 | $9.92 | $944.76 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $964.34 | $28.93 | $9.92 | $1,003.19 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $1,021.07 | $30.63 | $9.92 | $1,061.62 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $1,077.79 | $32.33 | $9.92 | $1,120.04 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,134.52 | $34.04 | $9.92 | $1,178.48 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,191.24 | $35.74 | $9.92 | $1,236.90 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,247.97 | $37.44 | $9.92 | $1,295.33 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,304.69 | $39.14 | $9.92 | $1,353.75 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,361.42 | $40.84 | $9.92 | $1,412.18 |
| 3988 | General Inpatient w/ AIDS | $979.14 | $29.37 | $9.92 | $1,018.43 |
| 3989 | Routine Home Care w/ AIDS Escort | $353.13 | $10.59 | $9.92 | $373.64 |
| 3991 | Service Intensity Add–on | $50.46 | $1.51 | $0.00 | $51.97 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Poughkeepsie
Hospice Rate Sheets for the Counties of: DUTCHESS
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $176.31 | $5.29 | $9.92 | $191.52 |
| 3946 | Inpatient Respite | $194.96 | $5.85 | $9.92 | $210.73 |
| 3947 | General Inpatient Care | $806.85 | $24.21 | $9.92 | $840.98 |
| 3948 | Continuous Home Care – Min 8 Hours | $355.35 | $10.66 | $9.92 | $375.93 |
| 3949 | Continuous Home Care – Min 9 Hours | $399.77 | $11.99 | $9.92 | $421.68 |
| 3950 | Continuous Home Care – Min 10 Hours | $444.19 | $13.33 | $9.92 | $467.44 |
| 3951 | Continuous Home Care – Min 11 Hours | $488.61 | $14.66 | $9.92 | $513.19 |
| 3952 | Continuous Home Care – Min 12 Hours | $533.03 | $15.99 | $9.92 | $558.94 |
| 3953 | Continuous Home Care – Min 13 Hours | $577.45 | $17.32 | $9.92 | $604.69 |
| 3954 | Continuous Home Care – Min 14 Hours | $621.87 | $18.66 | $9.92 | $650.45 |
| 3955 | Continuous Home Care – Min 15 Hours | $666.29 | $19.99 | $9.92 | $696.20 |
| 3956 | Continuous Home Care – Min 16 Hours | $710.71 | $21.32 | $9.92 | $741.95 |
| 3957 | Continuous Home Care – Min 17 Hours | $755.13 | $22.65 | $9.92 | $787.70 |
| 3958 | Continuous Home Care – Min 18 Hours | $799.55 | $23.99 | $9.92 | $833.46 |
| 3959 | Continuous Home Care – Min 19 Hours | $843.96 | $25.32 | $9.92 | $879.20 |
| 3960 | Continuous Home Care – Min 20 Hours | $888.38 | $26.65 | $9.92 | $924.95 |
| 3961 | Continuous Home Care – Min 21 Hours | $932.80 | $27.98 | $9.92 | $970.70 |
| 3962 | Continuous Home Care – Min 22 Hours | $977.22 | $29.32 | $9.92 | $1,016.46 |
| 3963 | Continuous Home Care – Min 23 Hours | $1,021.64 | $30.65 | $9.92 | $1,062.21 |
| 3964 | Continuous Home Care – Min 24 Hours | $1,066.06 | $31.98 | $9.92 | $1,107.96 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $9.75 | $0.29 | $0.50 | $10.54 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $305.43 | $9.16 | $9.92 | $324.51 |
| 3970 | Routine Home Care w/Escort | $194.05 | $5.82 | $9.92 | $209.79 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $402.31 | $12.07 | $9.92 | $424.30 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $452.60 | $13.58 | $9.92 | $476.10 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $502.89 | $15.09 | $9.92 | $527.90 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $553.18 | $16.60 | $9.92 | $579.70 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $603.47 | $18.10 | $9.92 | $631.49 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $653.75 | $19.61 | $9.92 | $683.28 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $704.04 | $21.12 | $9.92 | $735.08 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $754.33 | $22.63 | $9.92 | $786.88 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $804.62 | $24.14 | $9.92 | $838.68 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $854.91 | $25.65 | $9.92 | $890.48 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $905.20 | $27.16 | $9.92 | $942.28 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $955.49 | $28.66 | $9.92 | $994.07 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $1,005.78 | $30.17 | $9.92 | $1,045.87 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $1,056.06 | $31.68 | $9.92 | $1,097.66 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $1,106.35 | $33.19 | $9.92 | $1,149.46 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,156.64 | $34.70 | $9.92 | $1,201.26 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,206.93 | $36.21 | $9.92 | $1,253.06 |
| 3988 | General Inpatient w/ AIDS | $896.73 | $26.90 | $9.92 | $933.55 |
| 3989 | Routine Home Care w/ AIDS Escort | $323.17 | $9.70 | $9.92 | $342.79 |
| 3991 | Service Intensity Add–on | $45.96 | $1.38 | $0.00 | $47.34 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Rochester
Hospice Rate Sheets for the Counties of: LIVINGSTON, MONROE, ONTARIO, ORLEANS, WAYNE
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $144.80 | $4.34 | $9.92 | $159.06 |
| 3946 | Inpatient Respite | $167.01 | $5.01 | $9.92 | $181.94 |
| 3947 | General Inpatient Care | $671.73 | $20.15 | $9.92 | $701.80 |
| 3948 | Continuous Home Care – Min 8 Hours | $291.84 | $8.76 | $9.92 | $310.52 |
| 3949 | Continuous Home Care – Min 9 Hours | $328.32 | $9.85 | $9.92 | $348.09 |
| 3950 | Continuous Home Care – Min 10 Hours | $364.80 | $10.94 | $9.92 | $385.66 |
| 3951 | Continuous Home Care – Min 11 Hours | $401.28 | $12.04 | $9.92 | $423.24 |
| 3952 | Continuous Home Care – Min 12 Hours | $437.76 | $13.13 | $9.92 | $460.81 |
| 3953 | Continuous Home Care – Min 13 Hours | $474.24 | $14.23 | $9.92 | $498.39 |
| 3954 | Continuous Home Care – Min 14 Hours | $510.72 | $15.32 | $9.92 | $535.96 |
| 3955 | Continuous Home Care – Min 15 Hours | $547.20 | $16.42 | $9.92 | $573.54 |
| 3956 | Continuous Home Care – Min 16 Hours | $583.68 | $17.51 | $9.92 | $611.11 |
| 3957 | Continuous Home Care – Min 17 Hours | $620.16 | $18.60 | $9.92 | $648.68 |
| 3958 | Continuous Home Care – Min 18 Hours | $656.64 | $19.70 | $9.92 | $686.26 |
| 3959 | Continuous Home Care – Min 19 Hours | $693.12 | $20.79 | $9.92 | $723.83 |
| 3960 | Continuous Home Care – Min 20 Hours | $729.60 | $21.89 | $9.92 | $761.41 |
| 3961 | Continuous Home Care – Min 21 Hours | $766.08 | $22.98 | $9.92 | $798.98 |
| 3962 | Continuous Home Care – Min 22 Hours | $802.56 | $24.08 | $9.92 | $836.56 |
| 3963 | Continuous Home Care – Min 23 Hours | $839.04 | $25.17 | $9.92 | $874.13 |
| 3964 | Continuous Home Care – Min 24 Hours | $875.52 | $26.27 | $9.92 | $911.71 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.35 | $0.25 | $0.50 | $9.10 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $250.84 | $7.53 | $9.92 | $268.29 |
| 3970 | Routine Home Care w/Escort | $162.54 | $4.88 | $9.92 | $177.34 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $308.47 | $9.25 | $9.92 | $327.64 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $347.03 | $10.41 | $9.92 | $367.36 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $385.58 | $11.57 | $9.92 | $407.07 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $424.14 | $12.72 | $9.92 | $446.78 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $462.70 | $13.88 | $9.92 | $486.50 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $501.26 | $15.04 | $9.92 | $526.22 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $539.82 | $16.19 | $9.92 | $565.93 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $578.38 | $17.35 | $9.92 | $605.65 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $616.93 | $18.51 | $9.92 | $645.36 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $655.49 | $19.66 | $9.92 | $685.07 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $694.05 | $20.82 | $9.92 | $724.79 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $732.61 | $21.98 | $9.92 | $764.51 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $771.17 | $23.14 | $9.92 | $804.23 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $809.73 | $24.29 | $9.92 | $843.94 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $848.28 | $25.45 | $9.92 | $883.65 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $886.84 | $26.61 | $9.92 | $923.37 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $925.40 | $27.76 | $9.92 | $963.08 |
| 3988 | General Inpatient w/ AIDS | $746.56 | $22.40 | $9.92 | $778.88 |
| 3989 | Routine Home Care w/ AIDS Escort | $268.58 | $8.06 | $9.92 | $286.56 |
| 3991 | Service Intensity Add–on | $37.74 | $1.13 | $0.00 | $38.87 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Syracuse
Hospice Rate Sheets for the Counties of: MADISON, ONONDAGA, OSWEGO
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $160.43 | $4.81 | $9.92 | $175.16 |
| 3946 | Inpatient Respite | $180.88 | $5.43 | $9.92 | $196.23 |
| 3947 | General Inpatient Care | $738.74 | $22.16 | $9.92 | $770.82 |
| 3948 | Continuous Home Care – Min 8 Hours | $323.34 | $9.70 | $9.92 | $342.96 |
| 3949 | Continuous Home Care – Min 9 Hours | $363.76 | $10.91 | $9.92 | $384.59 |
| 3950 | Continuous Home Care – Min 10 Hours | $404.18 | $12.13 | $9.92 | $426.23 |
| 3951 | Continuous Home Care – Min 11 Hours | $444.59 | $13.34 | $9.92 | $467.85 |
| 3952 | Continuous Home Care – Min 12 Hours | $485.01 | $14.55 | $9.92 | $509.48 |
| 3953 | Continuous Home Care – Min 13 Hours | $525.43 | $15.76 | $9.92 | $551.11 |
| 3954 | Continuous Home Care – Min 14 Hours | $565.85 | $16.98 | $9.92 | $592.75 |
| 3955 | Continuous Home Care – Min 15 Hours | $606.26 | $18.19 | $9.92 | $634.37 |
| 3956 | Continuous Home Care – Min 16 Hours | $646.68 | $19.40 | $9.92 | $676.00 |
| 3957 | Continuous Home Care – Min 17 Hours | $687.10 | $20.61 | $9.92 | $717.63 |
| 3958 | Continuous Home Care – Min 18 Hours | $727.52 | $21.83 | $9.92 | $759.27 |
| 3959 | Continuous Home Care – Min 19 Hours | $767.93 | $23.04 | $9.92 | $800.89 |
| 3960 | Continuous Home Care – Min 20 Hours | $808.35 | $24.25 | $9.92 | $842.52 |
| 3961 | Continuous Home Care – Min 21 Hours | $848.77 | $25.46 | $9.92 | $884.15 |
| 3962 | Continuous Home Care – Min 22 Hours | $889.19 | $26.68 | $9.92 | $925.79 |
| 3963 | Continuous Home Care – Min 23 Hours | $929.60 | $27.89 | $9.92 | $967.41 |
| 3964 | Continuous Home Care – Min 24 Hours | $970.02 | $29.10 | $9.92 | $1,009.04 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $9.04 | $0.27 | $0.50 | $9.81 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $277.92 | $8.34 | $9.92 | $296.18 |
| 3970 | Routine Home Care w/Escort | $178.17 | $5.35 | $9.92 | $193.44 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $355.01 | $10.65 | $9.92 | $375.58 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $399.38 | $11.98 | $9.92 | $421.28 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $443.76 | $13.31 | $9.92 | $466.99 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $488.13 | $14.64 | $9.92 | $512.69 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $532.51 | $15.98 | $9.92 | $558.41 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $576.89 | $17.31 | $9.92 | $604.12 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $621.26 | $18.64 | $9.92 | $649.82 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $665.64 | $19.97 | $9.92 | $695.53 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $710.01 | $21.30 | $9.92 | $741.23 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $754.39 | $22.63 | $9.92 | $786.94 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $798.77 | $23.96 | $9.92 | $832.65 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $843.14 | $25.29 | $9.92 | $878.35 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $887.52 | $26.63 | $9.92 | $924.07 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $931.89 | $27.96 | $9.92 | $969.77 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $976.27 | $29.29 | $9.92 | $1,015.48 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $1,020.64 | $30.62 | $9.92 | $1,061.18 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $1,065.02 | $31.95 | $9.92 | $1,106.89 |
| 3988 | General Inpatient w/ AIDS | $821.04 | $24.63 | $9.92 | $855.59 |
| 3989 | Routine Home Care w/ AIDS Escort | $295.66 | $8.87 | $9.92 | $314.45 |
| 3991 | Service Intensity Add–on | $41.82 | $1.25 | $0.00 | $43.07 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Utica–Rome
Hospice Rate Sheets for the Counties of: MADISON, ONONDAGA, OSWEGO
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $151.56 | $4.55 | $9.92 | $166.03 |
| 3946 | Inpatient Respite | $173.01 | $5.19 | $9.92 | $188.12 |
| 3947 | General Inpatient Care | $700.71 | $21.02 | $9.92 | $731.65 |
| 3948 | Continuous Home Care – Min 8 Hours | $305.47 | $9.16 | $9.92 | $324.55 |
| 3949 | Continuous Home Care – Min 9 Hours | $343.65 | $10.31 | $9.92 | $363.88 |
| 3950 | Continuous Home Care – Min 10 Hours | $381.83 | $11.45 | $9.92 | $403.20 |
| 3951 | Continuous Home Care – Min 11 Hours | $420.02 | $12.60 | $9.92 | $442.54 |
| 3952 | Continuous Home Care – Min 12 Hours | $458.20 | $13.75 | $9.92 | $481.87 |
| 3953 | Continuous Home Care – Min 13 Hours | $496.38 | $14.89 | $9.92 | $521.19 |
| 3954 | Continuous Home Care – Min 14 Hours | $534.57 | $16.04 | $9.92 | $560.53 |
| 3955 | Continuous Home Care – Min 15 Hours | $572.75 | $17.18 | $9.92 | $599.85 |
| 3956 | Continuous Home Care – Min 16 Hours | $610.93 | $18.33 | $9.92 | $639.18 |
| 3957 | Continuous Home Care – Min 17 Hours | $649.12 | $19.47 | $9.92 | $678.51 |
| 3958 | Continuous Home Care – Min 18 Hours | $687.30 | $20.62 | $9.92 | $717.84 |
| 3959 | Continuous Home Care – Min 19 Hours | $725.48 | $21.76 | $9.92 | $757.16 |
| 3960 | Continuous Home Care – Min 20 Hours | $763.67 | $22.91 | $9.92 | $796.50 |
| 3961 | Continuous Home Care – Min 21 Hours | $801.85 | $24.06 | $9.92 | $835.83 |
| 3962 | Continuous Home Care – Min 22 Hours | $840.03 | $25.20 | $9.92 | $875.15 |
| 3963 | Continuous Home Care – Min 23 Hours | $878.22 | $26.35 | $9.92 | $914.49 |
| 3964 | Continuous Home Care – Min 24 Hours | $916.40 | $27.49 | $9.92 | $953.81 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.65 | $0.26 | $0.50 | $9.41 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $262.55 | $7.88 | $9.92 | $280.35 |
| 3970 | Routine Home Care w/Escort | $169.30 | $5.08 | $9.92 | $184.30 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $328.60 | $9.86 | $9.92 | $348.38 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $369.67 | $11.09 | $9.92 | $390.68 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $410.75 | $12.32 | $9.92 | $432.99 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $451.82 | $13.55 | $9.92 | $475.29 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $492.90 | $14.79 | $9.92 | $517.61 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $533.97 | $16.02 | $9.92 | $559.91 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $575.04 | $17.25 | $9.92 | $602.21 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $616.12 | $18.48 | $9.92 | $644.52 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $657.19 | $19.72 | $9.92 | $686.83 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $698.27 | $20.95 | $9.92 | $729.14 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $739.34 | $22.18 | $9.92 | $771.44 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $780.42 | $23.41 | $9.92 | $813.75 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $821.49 | $24.64 | $9.92 | $856.05 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $862.57 | $25.88 | $9.92 | $898.37 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $903.64 | $27.11 | $9.92 | $940.67 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $944.72 | $28.34 | $9.92 | $982.98 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $985.79 | $29.57 | $9.92 | $1,025.28 |
| 3988 | General Inpatient w/ AIDS | $778.77 | $23.36 | $9.92 | $812.05 |
| 3989 | Routine Home Care w/ AIDS Escort | $280.29 | $8.41 | $9.92 | $298.62 |
| 3991 | Service Intensity Add–on | $39.51 | $1.19 | $0.00 | $40.70 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
SMSA: Rural
Hospice Rate Sheets for the Counties of: ALLEGANY, CATTARAUGUS, CAYUGA, CHAUTAUQUA, CHENANGO, CLINTON, COLUMBIA, CORTLAND, DELAWARE, ESSEX, FRANKLIN, FULTON, GENESEE, HAMILTON, JEFFERSON, LEWIS, OTSEGO, SCHOHARIE, SCHUYLER, SENECA, ST. LAWRENCE, STEUBEN, SULLIVAN, TOMPKINS, ULSTER, WYOMING, YATES
| Rate Code |
Description | Base Rate | WRP Add–on * |
RTR Add–on * |
Total w/ addons |
|---|---|---|---|---|---|
| 3945 | Routine Home Care | $143.88 | $4.32 | $9.92 | $158.12 |
| 3946 | Inpatient Respite | $166.20 | $4.99 | $9.92 | $181.11 |
| 3947 | General Inpatient Care | $667.78 | $20.03 | $9.92 | $697.73 |
| 3948 | Continuous Home Care – Min 8 Hours | $289.98 | $8.70 | $9.92 | $308.60 |
| 3949 | Continuous Home Care – Min 9 Hours | $326.23 | $9.79 | $9.92 | $345.94 |
| 3950 | Continuous Home Care – Min 10 Hours | $362.48 | $10.87 | $9.92 | $383.27 |
| 3951 | Continuous Home Care – Min 11 Hours | $398.73 | $11.96 | $9.92 | $420.61 |
| 3952 | Continuous Home Care – Min 12 Hours | $434.98 | $13.05 | $9.92 | $457.95 |
| 3953 | Continuous Home Care – Min 13 Hours | $471.22 | $14.14 | $9.92 | $495.28 |
| 3954 | Continuous Home Care – Min 14 Hours | $507.47 | $15.22 | $9.92 | $532.61 |
| 3955 | Continuous Home Care – Min 15 Hours | $543.72 | $16.31 | $9.92 | $569.95 |
| 3956 | Continuous Home Care – Min 16 Hours | $579.97 | $17.40 | $9.92 | $607.29 |
| 3957 | Continuous Home Care – Min 17 Hours | $616.21 | $18.49 | $9.92 | $644.62 |
| 3958 | Continuous Home Care – Min 18 Hours | $652.46 | $19.57 | $9.92 | $681.95 |
| 3959 | Continuous Home Care – Min 19 Hours | $688.71 | $20.66 | $9.92 | $719.29 |
| 3960 | Continuous Home Care – Min 20 Hours | $724.96 | $21.75 | $9.92 | $756.63 |
| 3961 | Continuous Home Care – Min 21 Hours | $761.21 | $22.84 | $9.92 | $793.97 |
| 3962 | Continuous Home Care – Min 22 Hours | $797.45 | $23.92 | $9.92 | $831.29 |
| 3963 | Continuous Home Care – Min 23 Hours | $833.70 | $25.01 | $9.92 | $868.63 |
| 3964 | Continuous Home Care – Min 24 Hours | $869.95 | $26.10 | $9.92 | $905.97 |
| 3965 | Hospice Inpatient Respite Care Coinsurance Rate – | ||||
| 5% of 3946 | $8.31 | $0.25 | $0.50 | $9.06 | |
| 3966 | Drugs Coinsurance Rate | $1.00 | $0.00 | $0.00 | $1.00 |
| 3969 | Routine Home Care w/AIDS | $249.25 | $7.48 | $9.92 | $266.65 |
| 3970 | Routine Home Care w/Escort | $161.62 | $4.85 | $9.92 | $176.39 |
| 3971 | Continuous Home Care w/AIDS Min 8 Hours | $305.72 | $9.17 | $9.92 | $324.81 |
| 3972 | Continuous Home Care w/AIDS Min 9 Hours | $343.94 | $10.32 | $9.92 | $364.18 |
| 3973 | Continuous Home Care w/AIDS Min 10 Hours | $382.15 | $11.46 | $9.92 | $403.53 |
| 3974 | Continuous Home Care w/AIDS Min 11 Hours | $420.37 | $12.61 | $9.92 | $442.90 |
| 3975 | Continuous Home Care w/AIDS Min 12 Hours | $458.59 | $13.76 | $9.92 | $482.27 |
| 3976 | Continuous Home Care w/AIDS Min 13 Hours | $496.80 | $14.90 | $9.92 | $521.62 |
| 3977 | Continuous Home Care w/AIDS Min 14 Hours | $535.02 | $16.05 | $9.92 | $560.99 |
| 3978 | Continuous Home Care w/AIDS Min 15 Hours | $573.23 | $17.20 | $9.92 | $600.35 |
| 3979 | Continuous Home Care w/AIDS Min 16 Hours | $611.45 | $18.34 | $9.92 | $639.71 |
| 3980 | Continuous Home Care w/AIDS Min 17 Hours | $649.66 | $19.49 | $9.92 | $679.07 |
| 3981 | Continuous Home Care w/AIDS Min 18 Hours | $687.88 | $20.64 | $9.92 | $718.44 |
| 3982 | Continuous Home Care w/AIDS Min 19 Hours | $726.09 | $21.78 | $9.92 | $757.79 |
| 3983 | Continuous Home Care w/AIDS Min 20 Hours | $764.31 | $22.93 | $9.92 | $797.16 |
| 3984 | Continuous Home Care w/AIDS Min 21 Hours | $802.52 | $24.08 | $9.92 | $836.52 |
| 3985 | Continuous Home Care w/AIDS Min 22 Hours | $840.74 | $25.22 | $9.92 | $875.88 |
| 3986 | Continuous Home Care w/AIDS Min 23 Hours | $878.95 | $26.37 | $9.92 | $915.24 |
| 3987 | Continuous Home Care w/AIDS Min 24 Hours | $917.17 | $27.52 | $9.92 | $954.61 |
| 3988 | General Inpatient w/ AIDS | $742.17 | $22.27 | $9.92 | $774.36 |
| 3989 | Routine Home Care w/ AIDS Escort | $266.99 | $8.01 | $9.92 | $284.92 |
| 3991 | Service Intensity Add–on | $37.50 | $1.13 | $0.00 | $38.63 |
* WRR =´Worker Recruitment and Retention addon´ if applicable
* RTR =´Recruitment, Training and Retention addon´ if applicable
